DR. STEPHEN S KALLAOS (NPI# 1649349879) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1649349879 |
| Entity Type | Individual |
| Full Name | DR. STEPHEN S KALLAOS |
| Credential | DDS |
| Practice Address |
24099 Postal Ave Suite 102 Moreno Valley CA 92553-7709 |
| Mailing Address |
29 Oroville Irvine CA 92602-0923 |
| Practice Telephone | 9516011385 |
| Practice Fax Number | 9516011292 |
| Mailing Telephone | 7143179821 |
| Mailing Fax Number | 9516011385 |
| Enumeration Date | 2006-11-06 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223P0300X |
Dentist Specialization: Periodontics |
44903 | CA | Dental Providers |
| Street Address |
24099 POSTAL AVE SUITE 102 |
| City | MORENO VALLEY |
| State | CA |
| Zip Code | 92553-7709 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356546741 | Lynn Diaz | Dentist | 24099 Postal Ave, Suite 101, Moreno Valley, CA 92553-7709 | 2007-06-18 |
| 1487858106 | Kurt Otto Marcks | Dentist | 24099 Postal Ave, Suite 101, Moreno Valley, CA 92553-7709 | 2007-06-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104441559 | Tanya Gentle | Marriage & Family Therapist | 2319 Cottonwood Avenue, Building A Suite 110, Moreno Valley, CA 92553 | 2020-06-11 |
| 1275194227 | Antonio Pearce | Psychologist | 12968 Frederick Street, Suite D, Moreno Valley, CA 92553 | 2019-06-20 |
| 1346726486 | Elias Y. Rached | Chiropractor | 23846 Sunnymead Blvd Ste 4, Moreno Valley, CA 92553 | 2018-07-12 |
| 1952813420 | Shanaya Frederick | Driver | 14929 Spinnaker Lane, Moreno Valley, CA 92553 | 2017-10-24 |
| 1457879413 | R & C Logistic Services, LLC | Private Vehicle | 14768 Briana St, Moreno Valley, CA 92553 | 2017-08-30 |
| 1720505084 | Elda Pricila Hernandez | Behavioral Analyst | 24596 Atwood Ave.apt1, Moreno Valley, CA 92553 | 2017-08-28 |
| 1174044101 | Ps Medical Supplies Inc | Durable Medical Equipment & Medical Supplies | 24594 Sunnymead Blvd, Suite M, Moreno Valley, CA 92553 | 2017-06-29 |
| 1942736327 | Richard Pantoja Reyna | Licensed Vocational Nurse | 23119 Cottonwood Ave Bld A Suite 110, Moreno Valley, CA 92553 | 2017-05-04 |
| 1255872719 | Sibonisiwe Moyo Johnson | Nurse Practitioner | 22555 Alessandro Blvd Ste B, Moreno Valley, CA 92553 | 2017-03-16 |
| 1518311190 | Ryan Macavinta | Nurse Practitioner | 22765 Alessandro Blvd., Moreno Valley, CA 92553 | 2016-04-20 |
| Find all providers in zip 92553 | ||||
| Taxonomy Code | 1223P0300X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Periodontics |
| That specialty of dentistry which encompasses the prevention, diagnosis and treatment of diseases of the supporting and surrounding tissues of the teeth or their substitutes and the maintenance of the health, function and esthetics of these structures and tissues. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548365067 | Mohamed Amin Hassan | Dentist | 12900 Perris Blvd, Suite # 102, Moreno Valley, CA 92553-4135 | 2006-09-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982204780 | Richard Koh Dds Ms Inc. | Dentist | 11 Delano, Irvine, CA 92602-2462 | 2020-10-30 |
| 1225641293 | Richard T. Kao, Dds, Phd - Dental Corp. | Dentist | 1660 Willow St Ste 3, San Jose, CA 95125-5101 | 2020-08-28 |
| 1093325722 | Sergio Florencio Jr, Dds, Dmsc, Inc | Dentist | 1802 San Miguel Dr, Walnut Creek, CA 94596-8606 | 2020-08-06 |
| 1205463445 | Sharona Dayan, Dds, Inc | Dentist | 9735 Wilshire Blvd Ste 211, Beverly Hills, CA 90212-2102 | 2020-03-26 |
| 1215573522 | Vanessa Bikhazi | Dentist | 2372 Se Bristol St Ste A, Newport Beach, CA 92660-0755 | 2019-11-21 |
| 1063057008 | Robert Lacrampe | Dentist | 880 W 1st St Apt 526, Los Angeles, CA 90012-2473 | 2019-11-13 |
| 1376194639 | Snow Nakano & Lopez Professional Dental Corporation | Dentist | 868 Auto Center Dr Ste A, Palmdale, CA 93551-4691 | 2019-09-26 |
| 1659926285 | Suman Ramakumar Dds Inc | Dentist | 1171 Homestead Rd Ste 175, Santa Clara, CA 95050-5484 | 2019-08-09 |
| 1912567058 | Andrew Peterson Dmd Ms PC | Dentist | 9856 Hibiscus Ct, Alta Loma, CA 91737-3637 | 2019-06-20 |
| 1124686233 | Danoukh Dental Corp. | Dentist | 12271 La Mirada Blvd Ste 201, La Mirada, CA 90638-1336 | 2019-06-04 |
| Find all providers with the same taxonomy | ||||
| City | MORENO VALLEY |
| Zip Code | 92553 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.